The Mount Sinai OAIC's innovative mission is to stimulate, develop, and fund research to improve quality of life and independence of older adults with serious illness and their caregivers. The activities conducted during the first 4 years of our OAIC, building upon a foundation of pioneering research in aging and palliative care at Mount Sinai, have resulted in the Mount Sinai OAIC emerging as a key contributor in the movement to improve care for our nation's sickest patients. Since inception in 2009, we have: 1) defined a new field of geriatric palliative care; 2) recruited and trained a new generation of geriatric palliative care researchers (bucking a national trend) who are addressing the problems of our most vulnerable patients; 3) enhanced the evidence base for improving quality of life and independence in seriously ill older adults and their caregivers through innovative research; and 4) created a national network of geriatric palliative care researchers in collaboration with Mount Sinai's National Palliative Care Research Center (NCPRC) - a philanthropically supported center focused on promoting and funding palliative care research nationwide. Early stage investigators supported by the OAIC and NPCRC have received over $26 million in subsequent extramural federal funding. The objective of this first renewal is to 1) expand our comprehensive, transdisciplinary research program focused on improving quality of life and independence and developing and testing models of improving care for older adults living with serious illness; 2) identify, recruit and train leaders in aging and palliative care research; 3) expand a research infrastructure that will support new and ongoing research in the care of seriously ill older adults; and 4) develop a research center that bridges the transdisciplinary specialties of geriatrics and palliative care an that will serve as a model for research that has not been well addressed by either of these two specialties. We approach the work of advancing research in geriatric palliative care and its translation by considering the full range of translational research through a comprehensive framework of connected and coordinated activities that starts with creating a pipeline of trainees, supporting their research development, providing infrastructure and resources for research, nurturing and facilitating collaborative research, and ends with targeted efforts to disseminate the work to improve the life of older persons and their families. We bring together research resources at Mount Sinai, engage other experts in the region, and leverage a national network of experts and trainees through the NPCRC. To amplify the OAIC's impact, we also propose new innovative initiatives, including the formation of a new Pepper Center interest group and a new core focused on the often-neglected and final step of translational research-the implementation of research findings into practice. By strategically leveraging local and national resources and building on other successful programs, the OAIC proposes to maximize its impact by creating a Center that is comprehensive in scope, significant in its local impact, and national in its reach.